When a psychiatrist sees 40 patients a day, who benefits?

The NYT describes a 68 yo, old school psychiatrist from the therapy/analytic days, forced to convert his practice entirely to “15 minute med checks” (read: 5-10min) in order to stay afloat. In an office with leather chairs and African masks, he sees each patient in less time than it takes him to pee.

The readers will experience reflex responses: docs are chasing dollars. No one cares about patients anymore.

The part of this not stated in the article is how this is considerably more of a “wealth transfer” to Pharma than high drug prices or profits, a system so perfectly designed to boost Pfizer profits that one doubts it could be anything but intentional. The doc in the article says he has to do med checks in order to be profitable, but in fact the reimbursement scheme has guaranteed that all patients– defined not by diagnosis but by geography: anyone who walks through the door– will end up on meds. And they will never come off them, or the doc loses a patient.

In short, the current insurance scheme ensures 1) higher profits for Pharma; 2) the excess medicalization of emotional and behavioral issues; 3) the re-packaging of acute concerns as chronic pathology.

2 Responses to When a psychiatrist sees 40 patients a day, who benefits?

Also interesting is how the doctor is holding on to the trappings of old school psychiatry– the office, the chairs, the decorations– even though he is now practicing assembly line psychiatry. This isn’t a slam against him, but it shows how hard it is to change mid career.

My psychiatrist is like this, but I don’t see him on most med checks; I see a nurse practitioner. It’s easy to learn how to get any drug from a television commercial and I appreciate some of the drugs I’m on, so I pay attention to myself. It seems a lot to ask from someone who’s supposed to be mentally ill.